20131125 e health_introductie


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Introduction eHealth: why its important, definition, development and challenges to overcome.

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20131125 e health_introductie

  1. 1. eHealth, changing the value proposition in Healthcare Transform to the power of digital
  2. 2. Personal introduction Henk E. Bakker <henk.bakker@capgemini.com> – Principal consultant for IT in Healthcare • Capgemini Consulting Services NL – Background • Information Manager in several hospitals • National Project leader of ICT program of the DBC project • Project leader of National Electronic Medication Record project • 25 years of industry experience http://www.linkedin.com/pub/henk-bakker/4/280/95a @henkebakker Copyright © 2011 Capgemini Consulting. All rights reserved.
  3. 3. Agenda Why eHealth? Definition of eHealth and telemedicine eHealth from a patient perspective eHealth business models Acceleration of eHealth implementations Copyright © 2011 Capgemini Consulting. All rights reserved. 3
  4. 4. Why is eHealth necessary? 4
  5. 5. Healthcare systems are under pressure Chronic conditions increasingly pressurize health systems… Copyright © 2011 Capgemini Consulting. All rights reserved. 5
  6. 6. In particular the accessibility, affordability and quality of care are challenged due to…. Budget cuts Improved ‘diagnostic’ technologies Ageing population / growing demand Innovation in medication technology Future of Healthcare Shrinking and changing professional workforce Privacy, Security and Patient Consent Increasing service expectations Private competitors Copyright © 2011 Capgemini Consulting. All rights reserved.
  7. 7. The prevalence of chronic diseases is increasing rapidly: Some figures for the Netherlands Now in 10-20 years Diabetic 450.000 1.100.000 Alzheimer’s 120.000 500.000 Total Hip Knee It will become75.000 a 18.000 gigantic challenge !!! 24.000 55.000 Copyright © 2011 Capgemini Consulting. All rights reserved.
  8. 8. In order to remain viable or to regain viability, hospitals must realise efficiency gains of 15-20% over the next years and sustain themselves through growth Care Characteristics of Demand Ageing Demanding care consumer New diseases More demand caused by better supply Demand How can we close the gap? Government Response Characteristics of Supply Decreasing workforce No increase of care capacity Cost containment 2000 2010 Supply 2020 2030 Year Challenge for the Hospitals Copyright © 2011 Capgemini Consulting. All rights reserved.
  9. 9. The challenge: a paradigm shift from cure to care (quality of life) To Care From Cure Restore to health Ability to do things independently Restore to health Prevention Passive patient Active patient Expert Counsellor Intramural Extramural Institute Process Fragmentation Integration Monodisciplinary Multidisciplinary trade Evidence based Proactive Reactive Copyright © 2011 Capgemini Consulting. All rights reserved.
  10. 10. eHealth and telemedicine
  11. 11. eHealth is no other care, but it is designed differently Tele Treatment eConsult Professional and Patiënt Telemonitoring Self Service Patiënt eConsult Professional and Professional Self diagnosis and Prevention Electronic Health Record and Personal Health Record Alerts and Signalling Copyright © 2011 Capgemini Consulting. All rights reserved.
  12. 12. eHealth is….. Applications for the patient Applications that support the interaction between patient and healthcare provider (telemedicine) – Applications for the healthcare professional itself – Applications for the management of care continuity (information exchange of one provider to another) – Applications for the governance of care eHealth is often seen as "the application of ICT in Healthcare”; However eBusiness or eCommerce in Healthcare is more applicable Copyright © 2011 Capgemini Consulting. All rights reserved.
  13. 13. The potential of eHealth is enormous Increases efficiency Is economically interesting Supports early warning Can be anonymous eHealth contributes to: Health benefits (quality and gained lifetime) Increases self-reliance Social well being (longer in their own living environment, contact with peer groups) Increases the accessibility Efficiency of care and of processes (productivity) Reducing labour issues eHealth promotes : Empowerment of clients (they take their own responsibility) Opportunities for providers to meet customer needs Is 24/7 available Health benefits (quality and gained lifetime) Contributes to the quality of care eHealth is about substitution of care provisioning, not about more healthcare Copyright © 2011 Capgemini Consulting. All rights reserved.
  14. 14. eHealth from a patient perspective Realisation of the paradigm shift by eHealth
  15. 15. The Healthcare Provider - Patient Relationship shifts Fundamentally ....… Patient Centric Care Patient – Value determines choices Patient Engagement Healthcare delivery costs and efforts Patient Awareness Efficiency, patient satisfaction, and quality are key indicators for success Provider Driven Developing Care Providers embrace PatientValue and stimulate Patient Centric Care Patients are involved in healthcare services development and take responsibility for sustainable solutions Emerging Near Maturity Patient manages Personal Health Innovative Maturity/time …towards a service orientated model, developed for the patient, influenced by the patient and in which the patient is actively engaged Copyright © 2011 Capgemini Consulting. All rights reserved.
  16. 16. Adoption of digital technologies has become mainstream and the pace is drastically increasing … 2 billion people connected to the Internet Broadband penetration is exceeding 85% from 2012 in developed countries(1) CONNECTIVITY Access shifting from the wide-open web to semi-closed platforms: apps, social media…(2) 5 billion mobile phone subscribers in 2010 Accelerated pace of adoption Time needed for “mass adoption” (50 million users) Mobile Internet access globally outperforming desktop access in 2014(3) 68 y. Phone 50 y. Mobile already being the main device to access the Internet in developing countries Radio 38 y. TV 22 y. PC MOBILITY Plane 14 y. Internet 7 y. iPod 3 y. Facebook 2 y. People reading 10MB and hearing 400MB worth of material a day(4) DATA ABUNDANCE User-generated content exceeding the amount contributed by professional organizations(5) Sources: (1) In-stat, June 10, 2008 (2) The Web Is Dead. Long Live the Internet, Wired, 2010 (3) Morgan Stanley, 2010 (4) The Economist, November, 2006 (5) Data Center of China Internet, 2010 Copyright © 2011 Capgemini Consulting. All rights reserved.
  17. 17. … which leads to customers becoming more involved in the organization and getting more influence on clientservices ‘Once upon a time’ Inspiration Orientation Domain of “customers” Demand In the digital world Service Business scope Inspiration Orientation Demand Service Customer involvement Increased business influence Copyright © 2011 Capgemini Consulting. All rights reserved. 17
  18. 18. Interaction with the healthcare professional: the Digital Outpatient Clinic Copyright © 2011 Capgemini Consulting. All rights reserved.
  19. 19. Patient Empowerment • Personal health record • Doctor visit sheet (summary) • Self-diagnosis/triage based on decision trees • Provide comparative Health information • Prevention and lifestyle • Mutual contact (Forum) • Monitoring (engage your own care team) • Information on research programs Copyright © 2011 Capgemini Consulting. All rights reserved.
  20. 20. HealthVault Personal Health Record (PHR) platform Prevention Convenience Services Entertainment Pleasure Services Social Networks HealthVault Patient Empowerment Self management Personal Health Information is not safety-critical The information is owned and managed by the patient and can be made available for use in a professional healthcare setting Healthcare professionals have strict guidelines in the usage of patient-originated data A conscious process of incorporation of personal health information in the formal safety-critical systems and medical decision support is the responsibility of all professional healthcare provider organisations Privately stored public information on health, care and wellness Personal wellness data from the citizens and their wellness providers Personal health data from the citizen and their health care providers An EHR supports the medical doctor, the PHR empowers the citizen Copyright © 2011 Capgemini Consulting. All rights reserved.
  21. 21. Creating a Healthcare Information Ecosystem Professional Care Electronic prescriptions Medical record ECG monitor Education and screening Personal record Lifestyle Disease management Donor register Step counter Fitness monitor Healthcare spending Bloodsugar monitor Weight scales Heartrate monitor Epilepsy diary Blood pressure monitor Red is a tool Green is a device Personal Health Information sharing Copyright © 2011 Capgemini Consulting. All rights reserved.
  22. 22. eHealth business models What is the value proposition?
  23. 23. eHealth is patient centered, but the patients don’t pay us …. Patient Payer (Insurance) Healthcare Provider Copyright © 2011 Capgemini Consulting. All rights reserved.
  24. 24. From eHealth proposition to a sustainable business model Resources Offer Customer Co-creation Partner Network Core Capabilities Customer Relationship Value Configuration Value Proposition Distribution Channels Cost Structure PROFIT Revenue Streams (Financiële) Prestaties Financial Performance Customer Segment Bron: Vrij naar Alexander Osterwalder, Business Model Generation With a business model an organization describes, what value they create for their clients, how these services reach and support their customers, which resources should be used, with which third party should be partnered and finally, how they will make money Copyright © 2011 Capgemini Consulting. All rights reserved.
  25. 25. Acceleration of eHealth implementations
  26. 26. Introduction of eHealth is going (too) slow Health insurers (the payers) have so far ehealth approached competitively and achieved some successes But the Health insurers encounter barriers to further upscaling: – Termination of a project when the grant money runs out – The lack of a clear business case – Uncertainty about the effectiveness and efficiency of eHealth applications – Insufficient standardization and interoperability of eHealth applications – Lack of funding and a structural wide purchasing Embedding eHealth in organizational processes and changing the daily practice of healthcare professionals appear to be the most important critical success factors Copyright © 2011 Capgemini Consulting. All rights reserved.
  27. 27. Two dimensions spell out four different types of digital maturity • • BEGINNERS Fashionista have implemented or experimented with many DIGIRATI Digital Intensity FASHIONISTAS Beginners do very little with advanced digital capabilities, although they may be mature with more traditional applications such as ERP or electronic commerce. Although companies may be Beginners by choice, more often than not they are in this quadrant by accident. sexy digital applications. Some of these initiatives may create value, but many do not. While they may look good together, they are not implemented with the vision of gaining synergies among the items. CONSERVATIVES • Conservatives • Digirati Transformation Management Intensity favor prudence over innovation. They understand the need for a strong unifying vision as well as for governance and corporate culture to ensure investments are managed well. However, they are typically skeptical of the value of new digital trends, sometimes to their detriment. truly understand how to drive value with digital transformation. They combine a transformative vision, careful governance and engagement, with sufficient investment in new opportunities. Copyright © 2011 Capgemini Consulting. All rights reserved.
  28. 28. Digital Leaders show common patterns: the Digital DNA Focus Investments on where they choose to Excel Digitally Invest 100% in transformation management Digital Leaders Combine Digital Capabilities to Exploit Synergies Use Digital Technologies to Transform their Business Models Copyright © 2011 Capgemini Consulting. All rights reserved.
  29. 29. Our two-year research program with MIT provides some useful pointers for successfully executing a digital transformation Conducting a digital (eHealth) transformation requires taking action in four key areas: framing, investing, engaging, and sustaining. Sustain the Transformation Frame the Digital Challenge • Build Capabilities • Measure & Monitor Sustain Frame • Understand the impact • Assess Digital Maturity • Develop & Align around a Vision Engage Focus Engage the Organization • Signal and Mobilize • Govern across silos • Evolve Culture/ adapt Work Practices Focus Investments • Invest in Digitally-Enabled Initiatives • Adapt your Business Model Copyright © 2011 Capgemini Consulting. All rights reserved.
  30. 30. We discovered that many common perceptions about digital transformation were actually myths, which can lead executives to make unfortunate and costly decisions “Many common perceptions about digital transformation are actually myths Fortunately, our global survey of nearly 400 large firms, supplemented by 157 in-depth interviews with senior executives in more than 50 large companies, provides factbased answers” Myth Reality Digital is primarily about the customer experience Huge opportunities exist also in efficiency, productivity & employee leverage Digital primarily matters only to technology or B2C companies Opportunities exist in all industries with no exceptions Let 1000 flowers bloom; bottom-up activity is the right way to change Digital transformation must be led form the top If we do enough digital initiatives, we will get there The how of transformation is more important for driving overall performance Digital transformation will happen despite our IT Business/IT relationships are key, and in many companies they must be improved Digital transformation approach is different for every industry and company Digital Leaders exhibit a common DNA In our industry we can wait and see how digital develops There are digital leaders outperforming their peers in every industry today Copyright © 2011 Capgemini Consulting. All rights reserved.
  31. 31. Critical Success Factors for eHealth up scaling eHealth is an issue for board members: It is about organizational strategy, not IT. The perception of the professionals: eHealth should be given a place in the “hearts” and “minds” of healthcare professionals Funding: From projectfunding, subsidies to structurally embedded in the healthcare funding system Business as Usual: Application of eHealth should be part of the (development of) regular daily care Future proof: “Is Cloud technology a Game Change? Business says Yes; IT says No!” (Andy Mulholland, Capgemini CTO) The acceptance of digital services in the private sector in most EU countries makes it likely that many other basic conditions for up scaling of eHealth are properly fulfilled Copyright © 2011 Capgemini Consulting. All rights reserved.